Updated meta-analysis of prevention of cardiovascular mortality by regular physical activity

Exercise Testing in Sports Medicine

Background Bicycle and treadmill exercise tests are used in sports medicine and occupational medicine to detect latent disease, to monitor treatment, and to measure patients' physical performance ability and reserve. In this review, we describe the indications, contraindications, and manner of performance of these tests, along with the variables tested, criteria for evaluation, (sub)maximal stress, and the factors that affect these tests, including age, sex, and medications. Methods This review is based on pertinent articles retrieved by a selective literature search and on the ergometry guidelines of four medical specialty societies. Results The proper performance of ergometric stress test…

Rezept für Bewegung in der Nephrologie

ZusammenfassungDie Behandlung der chronischen Niereninsuffizienz (chronic kidney disease, CKD) in Klinik und Praxis, auch unter der Dialysetherapie, beinhaltet stets eine umfangreiche medikamentöse Gabe und eine regelmäßige Überwachung. Die Niereninsuffizienz als chronische Erkrankung gehört zu der Gruppe von Krankheiten, die auch von einer nicht medikamentösen Therapie profitiert – nämlich von einer regelmäßigen körperlichen Aktivität. Trotz zahlreicher Publikationen zu diesem Thema werden Bewegung und körperliche Aktivität noch zu wenig bei Patienten mit CKD eingesetzt. Mit den Ergebnissen des Trainings während der Dialyse und dem Rezept für Bewegung gibt es effektive Ansätze, die Faktore…

Exercising recommendations for paroxysmal AF in young and middle-aged athletes (PAFIYAMA) syndrome.

We have recently described a new syndrome: strenuous endurance exercise-related atrial fibrillation (AF) under the acronym of ‘paroxysmal AF in young and middle-aged athletes’ (‘PAFIYAMA’). Provided that other risk factors for AF and underlying conditions have been excluded (1), the diagnostic criteria for this syndrome entail a number of conditions, classified as major and minor. An enhanced risk of AF has been clearly documented in endurance athletes (top-class, elite and recreational) (2-5), and such risk typically ranges between 1.2- to 15-fold compared to the general, sedentary population (the better cardiovascular fitness, the higher incidence of AF) (6-11). Anecdotally, the last auth…

Medical evaluation of athletes: Exercise testing

Exercise testing in athletes is used to (a) evaluate baseline fitness and prescribe an exercise program or training zones, (b) evaluate continued progress after engaging in exercise training over a period of time, (c) diagnose cardiopulmonary conditions affecting exercise performance, and, (d) provoke arrhythmias or evaluate hemodynamic response to exercise in an athlete with a known cardiovascular condition to determine whether it is safe to participate in competitive sports. Exercise testing is not part of routine pre-participation (PPS) screening; however, it can supplement the clinical work-up of athletes with pathological findings during PPS and/or with symptoms. In several conditions …

Koronare Herzkrankheit – Prävalenz, Bedeutung und Implikationen für die Prävention und Gesundheitsförderung

Die koronare Herzkrankheit ist eine der haufigen Herz-Kreislauf-Erkrankungen. Sie liegt mit an erster Stelle aller Erkrankungen. Die Fruherkennung wie auch die Behandlung der akuten und chronischen Form ist Grundlage fur eine bessere Uberlebensrate und eine Steigerung der Lebensqualitat der Erkrankten. Wichtig ist zudem die Rehabilitation nach einer Herzerkrankung sowie vor allem die Primar- und Sekundarpravention. Sie umfassen die Senkung der Risikofaktoren und einen gesunden Lebensstil. Im Rahmen dieser Ubersicht wird besonders die Rolle der korperlichen Aktivitat dargestellt. Sie ist von zentraler Bedeutung, da mit regelmasiger korperlicher Aktivitat die Mehrzahl der Risiken erheblich ge…

No evidence of adverse cardiac remodeling in former elite endurance athletes

Background: The impact of high exercise loads on a previously healthy heart remains controversial. We examined the consequences of decades of strenuous endurance exercise at the highest competition level on heart dimensions and volumes as well as on serum biomarkers of cardiac fibrosis/remodeling. Methods and results: We compared echocardiographic measurements and serum biomarkers of cardiac fibrosis/remodeling [troponin I, galectin-3, matrix metallopeptidase-2 and -9, N-terminal pro-brain natriuretic peptide, carboxy-terminal propeptide of type I procollagen, and soluble suppressor of tumorigenicity-2 (sST-2)/interleukin(IL)-1R4] in 53 male athletes [11 former professional ('elite') and 42…

Inequality in the world of sports: Differences of pre-participation examination in athletes in high- versus low-income countries.

Wall motion characteristic of the right pulmonary artery in the suprasternal echocardiogram

This study describes the motion pattern of the right pulmonary artery (RPA) as it can be assessed from the suprasternal echocardiogram. The motion characteristic of the RPA is dependent on hemodynamic factors within the lumen of the RPA and those within the left atrium and the aortic arch. During atrial contraction the superior wall of the left atrium separates from the inferior wall of the RPA (IWRPA) and produces an "a" dip in the wall motion of the IWRPA. During isovolumic contraction the RPA is shifted upward (IC point). The incisura in the pulmonary artery pressure curve reflecting pulmonic valve closure can be seen by a sudden decrease in the diameter of the RPA (PC point). In conditi…

Echocardiography in assessing acute pulmonary hypertension due to pulmonary embolism.

Eighteen patients with acute pulmonary embolism were studied with right heart catheterization and M mode echocardiography. No patient had evidence of preexisting cardiopulmonary disease; pulmonary embolism was documented with pulmonary angiography. The mean pulmonary arterial pressure correlated with the angiographic severity index of embolic obstruction (r = 0.61, p 2 , p 2 ) and in 5 patients with acute pulmonary embolism and a mean normal pulmonary arterial pressure (10.9 ± 0.4 mm/m 2 ). For all measurements the index size of the right pulmonary artery correlated with the mean pulmonary arterial pressure (r = 0.84, p

Kardiovaskuläre Effekte von Lorcainid, einer neuen antiarrhythmischen Substanz

Wir untersuchten die kardiovaskularen Effekte eines neuen und sehr wirksamen Antiarrhythmicums vom Lokalanasthetika-Typ. Folgende Parameter wurden wahrend einer diagnostischen Herzkatheteruntersuchung gemessen: Aortendruck, Pul- monalarteriendruck, Herzminutenvolumen, linksventrikularer Druck und dp/dt max. Nach i.v. Gabe von Lorcainid (2 mg/kg) kam es zu einer zeit- und dosisabhangigen Verminderung aller Kontraktilitatsindizes: dp/dt max. wurde maximal um 18.75% gegenuber der Ausgangslage reduziert. Alle Veranderungen waren bis zur 15. min nach Infusionsende maximal und zeigten innerhalb von 30 min eindeutige Ruckbildungstendenz. Der systolische Aortendruck, der linksventrikulare Druck, da…

Atrial fibrillation in highly trained endurance athletes — Description of a syndrome

Atrial fibrillation (AF) is the most common heart arrhythmia, the risk of which typically increases with age. This condition is commonly associated with major cardiovascular diseases and structural heart damage, while it is rarely observed in healthy young people. However, increasing evidence indicates that paroxysmal AF can also onset in young or middle-aged and otherwise healthy endurance athletes (e.g., cyclists, runners and cross-country skiers). Here we review the topic of AF associated with strenuous endurance exercise (SEE), for example cycling, running and cross-country skiing, especially at a competitive level, and we propose the definition of a new syndrome based on the accumulati…